Chew on this

Dental issues are the No. 1 cause of kids' surgeries

shutterstock.comBrushing your way to healtH: Dental decay in children is the No. 1 reason why children are treated in hospitals in Canada, so many dentists recommend that parents brush their kid's teeth for them even into the early teens.

Given they're key to good health — after all, how can you eat properly if you only have a few little stumps in your mouth? — we've all looked after our teeth since we were kids, right?

Well, I thought so, at least until I came across a recent BBC report that raised my eyebrows. Rotten teeth in kids is so rampant in the U.K. that the Royal College of Surgeons recommends that parents supervise if not actually brush their children's teeth until they're 14. More surprises: experts here in B.C. back that up, albeit with a qualifier.

"A lot of teenagers go through it as well, but with a lot of 13- or 14-year-olds it probably won't sit very well to say, come let me see if you've done a good job on your teeth. But it would be really good because some of (their teeth) are just horrible," says Bruce Ward, a North Vancouver dentist and spokesperson for the British Columbia Dental Association.

According to a study done by the Canadian Institute for Health Information, dental decay in children is the No. 1 reason why children are treated in hospitals in Canada. Each year, about 19,000 kids aged one to five have dental surgery for what's officially known as early childhood caries — what you or I usually call cavities.

It all starts when the bacteria in our mouths turn sugars into acid. The sugar first takes the form of plaque that's like white fuzz on the teeth.

If left unchecked, the condition can be so severe youngsters need general anesthesia for treatment. In some cases, the teeth are so decayed and gums so inflamed, all the baby teeth have to be removed.

"It's a major, major user of E.R. time in our hospital systems," says Dr. Ward. "And it's wicked, too, when you actually see it... Most of these kids are so young they need to go straight to a specialist or into B.C. Children's Hospital and they need to be put out for it because they're just too small to deal with it.

"These are not little cavities, these are teeth rotten to the gum line — they are totally destroyed."

The impacts, as you can imagine, can be extensive, putting the lie to an attitude a lot of parents have — oh, it doesn't matter, it's just their baby teeth.

The first frontier is pain, which many youngsters are unable to verbalize. One of the mothers in the BBC report said her three-year-old son had been in pain half his short, sweet life.

"So many children can't eat because their teeth are so painful because they've got caries," says Dr. Ward. "And that affects their growth and development."

Baby teeth are much softer and more fragile than permanent teeth, and they have lots of nerves that are much closer to the surface than they are in permanent teeth.

"So quite often when a child gets a cavity if it was an adult and it was the same size, it would be no problem, but in a baby tooth that cavity has gone right into the nerve," he adds.

And there are more issues. Rotten teeth look ugly, and if the teeth are actually missing they can negatively affect tongue position and speech, which impact's a youngster's confidence and social interactions. As well, baby teeth are important placeholders so teeth don't drift. They also guide permanent teeth coming in, just like the guidance structures for launching rockets.

So this is where good parental guidance comes in.

"A lot of kids don't know how to brush. Quite often parents give their kids a toothbrush and let them go for it. They don't look, don't watch. And the kids just kind of chew on the toothbrush for a while," says Dr. Ward, noting that kids are notorious for missing the areas where teeth meet the gums, and the backs and sides of their teeth.

"All of sudden we end up with this plaque all over the teeth and when you clean it off the teeth start to look pitted, because the plaque that sits on the teeth has a high acid content that starts to demineralize the teeth."

"Lift your child's lip" is the well-founded theme of dental health campaigns. So if you don't actually brush your youngster's teeth, at least check them all carefully — lift those lips! — until you're sure they're doing a good job brushing, even if they're teenagers.

For babies and toddlers, don't, repeat, don't do things like give them a bottle of milk or juice to suck on at bedtime, or dip the nipple in honey. That English mom with the three-year-old boy was baffled because her child never ate sweets — but he was given bottles of juice or sweetened tea regularly.

Dr. Ward says if you have to give your toddler a bottle to put her to bed, use plain water, nothing else. And if you give them milk or juice during the day, brush their teeth, or at least rinse their mouths with water afterward. Even the sugar in breast milk builds up in the mouth and ferments all night long, so after nursing, make sure your baby's mouth isn't full of milk then clean it out with a clean washcloth.

Once your kids start brushing, Dr. Ward recommends a toothpaste with fluoride if your drinking water does not contain any naturally. It strengthens kids' teeth (and exposed roots in adults) and does no harm. Whatever toothpaste your kids use, they don't need more than the equivalent of a grain of rice and make sure they don't use their toothbrush way past its prime. If the bristles are splayed, it's time for a new one — a small, soft, kids-sized brush.

Many of these tips are good for adults, too. And if you've been using a whitening toothpaste, beware. My own dentist advised me those whiteners make our teeth sensitive. Why do you think there are so many desensitizing toothpastes on the market now?

The other ageless tip is visit your dentist often, before a painful crisis flares up. B.C. Dental Association suggests taking your youngster to the dentist before anything is wrong, so she gets to hang out, see the cool equipment like Mr. Thirsty (the suction device) and get a fun prize. Even adults would enjoy that!

Glenda Bartosh is an award-winning journalist who is learning to like going to the dentist.